Insulinoma natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Overview

If left untreated, patients with insulinoma may progress to develop autonomic symptoms, neuroglycopenenic symptoms, and symptoms of catecholaminergic response. Common complications of insulinoma include intestinal obstruction, pleural effusion, hemorrhage, fistula formation, and diabetes mellitus.

Natural History

• If left untreated, patients with insulinoma may progress to develop:

• Autonomic symptoms

• Diaphoresis
• Tremor
• Palpitations

• Neuroglycopenenic symptoms

• Confusion
• Behavioral change
• Personality change
• Visual disturbance
• Seizures
• Coma

• Symptoms of catecholaminergic response

• Tremulousness
• Palpitations
• Sweating
• Hunger
• Anxiety
• Nausea

• They have a very slow growth rate compared to most malignant tumors.

Complications

Common complications of insulinoma include:

• Intestinal obstruction
• Pleural effusion
• Hemorrhage
• Fistula formation
• Diabetes mellitus

Prognosis

Most patients with benign insulinomas can be cured with surgery. Persistent or recurrent hypoglycemia after surgery tends to occur in patients with multiple tumors. About two percent of patients develop diabetes mellitus after their surgery.

References

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